Worse Hearing Loss Research Articles

The impact of hearing loss and cochlear implantation on the quality of life in children

BackgroundThis study evaluates the Quality of Life (QoL) in children with moderate to profound hearing impairments using cochlear implants (CIs), compared to those with normal hearing. It explores the impacts of hearing loss and the effectiveness of CIs in pediatric populations. MethodsConducted at a tertiary care academic center, this cross-sectional study included children aged 13–18. Participants were divided into three groups: normal hearing, yet to be treated moderate or worse hearing loss (uHL), and CI users. Demographic data were collected, and the QoL was assessed using the Hearing Environments and Reflection of Quality of Life (HEAR-QL) questionnaire, with scores across various subdomains compared. ResultsOf the 79 children meeting the inclusion criteria, 38 % had normal hearing, 29 % had at least moderate HL, and 33 % were CI users. Statistically significant differences in HEAR-QL scores were found among the groups. The normal hearing group reported the highest scores. In the subdomain of hearing circumstances and academic performance, CI users showed no significant difference from the normal hearing group, unlike those with untreated uHL who scored lower. However, in social interaction and emotional well-being subdomains, CI users' scores were lower than those of the normal hearing group but similar to the uHL group. ConclusionChildren with CIs show comparable QoL in auditory capabilities to their normal hearing peers but experience significant challenges in psychosocial and emotional areas. This indicates that while CIs can improve hearing-related quality of life, they do not fully address the psychosocial impacts of hearing loss.

Prevalence and Characteristics of Veterans with Severe Hearing Loss: A Descriptive Study.

Hearing loss is common among Veterans, and extensive hearing care resources are prioritized within the Veterans Administration (VA). Severe hearing loss poses unique communication challenges with speech understanding that may not be overcome with amplification. We analyzed data from the VA Audiometric Repository between 2005 and 2017 and the relationship between hearing loss severity with speech recognition scores. We hypothesized that a significant subset of Veterans with severe or worse hearing loss would have poor unaided speech perception outcomes even with adequate audibility. Sociodemographic characteristics and comorbidities were compiled using electronic medical records as was self-report measures of hearing disability. We identified a cohort of 137,500 unique Veterans with 232,789 audiograms demonstrating bilateral severe or worse hearing loss (four-frequency PTA > 70 dB HL). The median (IQR; range) age of Veterans at their first audiogram with severe or worse hearing loss was 81 years (74 to 87; 21-90+), and a majority were male (136,087 [99%]) and non-Hispanic white (107,798 [78.4%]). Among those with bilateral severe or worse hearing loss, 41,901 (30.5%) also had poor speech recognition scores (<50% words), with greater hearing loss severity correlating with worse speech perception. We observed variability in speech perception abilities in those with moderate-severe and greater levels of hearing loss who may derive limited benefit from amplification. Veterans with communication challenges may warrant alternative approaches and treatment strategies such as cochlear implants to support communication needs.

Hearing Loss in Older People With Schizophrenia: Audiologic Characteristics and Association With Psychosocial Functioning

The severity and impact of hearing deficits among adults with schizophrenia spectrum disorders may become increasingly relevant with advancing age. This study evaluated hearing ability and associated psychosocial functioning among older adults aged 50-70. Cross-sectional analysis. Four outpatient psychiatry clinics in New York City. Individuals aged 50-70 years with diagnoses of schizophrenia or schizoaffective disorder. Unaided pure tone air conduction audiometry conducted using a portable audiometry system determined the pure tone average (PTA) hearing threshold across four frequencies: 500, 1k, 2k, and 4k Hz. Better ear PTA defined the hearing threshold. Audiometry data retrieved from the U.S. National Health and Nutrition Examination Survey aided interpretation of sample hearing loss rates. Standard measures evaluated psychiatric symptoms, perceived impact of hearing impairment, loneliness, and quality of life. Among audiometry completers (N = 40), 35% (n = 14) demonstrated subclinical hearing loss (16-25 dB) and 35% (n = 14) had mild or worse hearing loss (≥26 dB). Rates were higher than expected based on age-based population data. Those who perceived hearing handicap rated it moderate (12.2%) or severe (7.3%); those who perceived tinnitus rated the impact as mild to moderate (12.2%) or catastrophic (2.4%). Neither psychiatric symptoms nor interviewer-rated quality of life was associated with hearing ability. Greater loneliness was significantly correlated with worse audiologic performance (r = 0.475, p <0.01) and greater perceived hearing handicap (r = 0.480, p <0.01). Identifying the need for hearing loss treatment among aging adults with schizophrenia spectrum disorders is important given the potential implications for social functioning, cognitive, and mental health.

COX inhibitor use during definitive radiotherapy is associated with worse hearing preservation in patients with vestibular schwannoma.

Patients with vestibular schwannoma undergoing definitive radiotherapy commonly experience hearing loss due to tumor and treatment effects; however, there is limited data evaluating concurrent medication use and other clinicopathologic factors associated with hearing preservation during and after radiotherapy. We performed a retrospective cohort study reviewing consecutive patients from 2004 to 2019 treated with radiotherapy for vestibular schwannoma at our institution. Ninety four patients with concurrent medications, baseline audiograms, and post-radiotherapy audiograms available were evaluable. We performed chi-squared analyses of the frequency of various clinicopathologic factors and t-tests evaluating the degree of hearing loss based on audiograms. At a median follow-up of 35.7months (mean: 46.5months), the baseline pure-tone average (PTA) of the ipsilateral ear worsened from 38.4 to 59.5dB following completion of radiotherapy (difference: 21.1, 95% CI 17.8-24.4dB, p < 0.001). 36 patients (38.3%) reported regular use of cyclooxygenase (COX) inhibitors (including acetaminophen and NSAIDs) during radiotherapy. The mean increase in PTA was significantly higher for patients taking COX inhibitors (25.8dB vs 18.1dB, p = 0.024) in the ipsilateral ear but not for the contralateral side. COX inhibitor use remained independently associated with worse PTA in the multivariate analysis. COX inhibitor use during definitive radiotherapy is associated with worse hearing loss in the affected ear but not for the contralateral side. This suggests the ototoxic effects of COX inhibitors may influence the effects of radiotherapy. These results could have clinical implications and warrant further investigation.

The Association of Hearing Loss with Hospitalization.

Individuals with hearing loss (HL) are at higher risk for hospitalizations, and may be for readmissions, compared with their hearing peers. The objective of this prospective study was to confirm retrospective studies suggesting that HL increases hospital readmissions, and, if confirmed, possible causes for it. A prospective cohort study of English-speaking patients >55 years old admitted to general medical and surgical floors at 2 large hospital systems in southeastern Michigan over a 2-year period was conducted. All patients underwent bedside audiometric testing. HL presence and severity were categorized using World Health Organization pure tone assessment parameters. Readmission rates, Charlson comorbidity index, socio-demographic and medical variables were obtained from Epic EMR databases. There were 1247 hospitalized patients enrolled. Of these, 76.8% had documented HL of which 50.5% (630) was mild HL and 26.3% (328) moderate or worse HL. Patients with any HL were older and more likely to be non-Hispanic, white, male, and had less education, lower health literacy, more comorbidities, and more difficulty communicating with their doctor. Readmission rates at 30 and 90-days were similar between HL and hearing groups, after adjusting for HL severity, Charlston index, and numerous potential confounders. Patients with HL do not seem to have higher rates of hospital readmissions. We did find high frequency of HL in hospitalized patients along with significant communication difficulties that patients had with their clinicians. These findings have implications for measures to improve patient-physician communication, potentially improving long-term health outcomes.

Hearing Aids Enhance Music Enjoyment in Individuals With Hearing Loss.

To investigate music appreciation in hearing aid (HA) users with varying levels of hearing loss (HL). Cross-sectional, within-subjects design. Tertiary medical center, community. Adults (≥18 yr) bilateral HA users. HA usage. Outcome variables included self-reported music enjoyment measures (pleasantness, musicality, naturalness) with and without HAs assessed with visual analogue scales (10 indicates highest level of enjoyment, 0 the least). Exposure variables include HL (better ear pure-tone average) and speech discrimination (word recognition scores [WRS]). Demographic information was collected. One hundred nine bilateral HA users completed the study. Mean (standard deviation) age was 66.6 years (16.8 yr); 52.3% were female patients. Mean (standard deviation) better ear pure-tone average was 51.1 dB (16.3 dB) HL. Increased severity of HL and worse WRS were associated with decreased music enjoyment ( p < 0.05) across all measures without HAs, adjusting for sex, age, education, race, HA type, age of HL diagnosis, duration of HL, duration of HA use, musical preference, and musical experience. However, these associations were attenuated or no longer significant with HA usage. Moreover, among all subjects, HAs (vs. no HAs) provided increased music enjoyment in pleasantness (HA, 6.94, no HA, 5.74; p < 0.01), musicality (HA, 7.35; no HA, 6.13, p < 0.01), and naturalness (HA, 6.75; no HA, 6.02; p = 0.02). HA users report increased music enjoyment with HAs compared with without HAs. Increased severity of HL and worse WRS were independently associated with decreased unaided music enjoyment. HA usage seems to mitigate this effect, particularly for those with worse HL.

Impact of cisplatin-induced hearing loss (CIHL) on patient-reported social and emotional functioning.

12120 Background: Cisplatin is one of the most commonly used ototoxic drugs, but no study has quantified the handicap imposed by CIHL in U.S. adult-onset cancer survivors. Identification of survivors with high degrees of handicap and related risk factors is vital, as hearing loss (HL) in the general population is strongly related to adverse health outcomes, including cognitive decline, dementia, and poor mental health and social well-being. Methods: Eligible testicular cancer survivors (TCS) (age &lt; 60 y at diagnosis, given first line cisplatin) completed comprehensive health surveys, including the validated 25-item Hearing Handicap Inventory for Adults (HHIA). HHIA quantifies emotional (13 items) and social difficulties (12 items) related to HL; for each scale (0-100%), based on their responses, TCS were grouped into 3 handicap levels: 0-16% (none/minimal), 17-42% (mild/moderate), and 43-100% (significant) following HHIA recommendations. A Spearman correlation evaluated the associations between increasing HL severity and HHIA group. The association between HL and reported cognitive dysfunction was evaluated by a logistic regression analysis adjusted for age, income, education, yrs since therapy, cisplatin dose, BMI, smoking, and hypertension, with results presented as OR[CI], p-value. Results: Among 213 TCS [median age at evaluation, 46 y (IQR: 38-52 y); median time since cisplatin completion, 10.6 y (IQR: 6.8-16.6 y)], CIHL was reported by 127 TCS (60%). Of TCS with CIHL, 31% reported some degree of related handicap (for total HHIA scale: 13% TCS and 18% TCS reporting mild/moderate and significant handicap, respectively). HL severity was significantly correlated with handicap level in all domains (social, ρ = 0.85, p &lt;.001; emotional, ρ = 0.72, p &lt;.001; and total, ρ = 0.81, p &lt;.001). Cognitive dysfunction was more commonly reported by TCS with CIHL than TCS without (35% and 22%, p =.049). HL was a significant independent predictor of cognitive dysfunction, 2.20 [1.09-4.47], p =.028. Since many patients with HL in the general population report tinnitus (TINN), and TINN may suggest a worse HL phenotype, we additionally adjusted for TINN severity and found a significant independent association for TINN and cognitive dysfunction, 1.49 [1.05-2.11], p = 0.027. Despite these outcomes, only 10% of TCS with HL used hearing aids (n = 13). Conclusions: After cisplatin chemotherapy, 60% TCS report CIHL, and TCS with CIHL report poorer social and emotional function. One in 5 TCS with CIHL reported significant overall handicap. Despite these outcomes, the low prevalence of hearing aid use suggests a potential clinical intervention that could improve social and emotional well-being. If confirmed, the possible association between CIHL with TINN and cognitive dysfunction may be of particular interest, as the Lancet Commission on Dementia Prevention (2020) identified untreated HL as a key modifiable risk factor.

Prevalence, risk factors and causes of hearing loss among adults 50 years and older in Santiago, Chile: results from a rapid assessment of hearing loss survey

Objective Among a representative sample of adults aged 50 years and older too (i) determine the prevalence of hearing loss, (ii) evaluate probable causes and risk factors of hearing loss, and (iii) assess the association between hearing loss measured by audiometry and self-report. Design A population-based survey of adults aged 50 and older in Santiago, Chile using the Rapid Assessment of Hearing Loss (RAHL) survey. Study sample 538 participants completed a questionnaire, which included questions on socio-demographic and health characteristics and self-reported hearing loss. Hearing and possible cause of hearing loss was assessed using pure tone audiometry (0.5–4.0 kHz), tympanometry, and otoscopy. Results The prevalence of any level of hearing loss in adults aged 50 years and older was 41% (95% CI 33.2, 49.2). In terms of aetiologies, 89.3% of ears with mild or worse hearing loss were classified as sensorineural. Otoscopy was abnormal in 10.7% of subjects with impacted earwax being the most common finding (4.4%) followed by chronic otitis media (3.5%). Hearing aid usage was 16.6%. Older age, lower socioeconomic position, lack of education, and solvent exposure were significantly associated with hearing loss. Conclusion Hearing loss among individuals aged over 50 years was common in Santiago, Chile.

Factors and Communication Impact of Unilateral Hearing Loss in U.S. Adults

Factors and Communication Impact of Unilateral Hearing Loss in U.S. Adults

Osteoporosis, bisphosphonate use, and risk of moderate or worse hearing loss in women.

Osteoporosis and low bone density (LBD) may be associated with higher risk of hearing loss, but findings are inconsistent and longitudinal data are scarce. Bisphosphonates may influence risk, but the relation has not been studied in humans. We longitudinally investigated associations of osteoporosis and LBD, bisphosphonate use, vertebral fracture (VF), hip fracture (HF), and risk of self-reported moderate or worse hearing loss. Longitudinal cohort study. The Nurses' Health Study (NHS) (1982-2016) and Nurses' Health Study II (NHS II) (1995-2017). Participants included 60,821 NHS women, aged 36-61 years at baseline, and 83,078 NHS II women, aged 31-48 years at baseline (total n=143,899). Information on osteoporosis, LBD, bisphosphonate use, VF, HF, and hearing status was obtained from validated biennial questionnaires. In a subcohort (n=3749), objective hearing thresholds were obtained by audiometry. Multivariable-adjusted Cox proportional hazards models were used to examine independent associations between osteoporosis (NHS), osteoporosis/LBD (NHS II), and risk of hearing loss. The multivariable-adjusted relative risk (MVRR, 95% confidence interval) of moderate or worse hearing loss was higher among women with osteoporosis or LBD in both cohorts. In NHS, compared with women without osteoporosis, the MVRR was 1.14 (1.09, 1.19) among women with osteoporosis; in NHS II, the MVRR was 1.30 (1.21, 1.40) among women with osteoporosis/LBD. The magnitude of the elevated risk was similar among women who did and did not use bisphosphonates. VF was associated with higher risk (NHS: 1.31 [1.16, 1.49]; NHS II: 1.39 [1.13, 1.71]), but HF was not (NHS: 1.00 [0.86, 1.16];NHS II: 1.15 [0.75,1.74]). Among participants with audiometric measurements, compared with women without osteoporosis/LBD, the mean multivariable-adjusted hearing thresholds were higher (i.e., worse) among those with osteoporosis/LBD who used bisphosphonates. Osteoporosis and LBD may be important contributors to aging-related hearing loss. Among women with osteoporosis, the risk of hearing loss was not influenced by bisphosphonate use.

The accuracy of parental suspicion of hearing loss in children

ObjectivesParental suspicion of hearing impairment in their children is generally inaccurate. Parents tend to underestimate hearing problems in their children. The aim of the study was to assess the accuracy of parental suspicion of hearing loss in their children. MethodsThis was a population-based, epidemiological study conducted in elementary schools in villages and small towns in Poland. The study sample was 64,750 children aged 6–13 years old. The children underwent hearing screening with pure-tone audiometry. The parents answered a question about hearing problems in their children.The outcome parameters were sensitivity, specificity, and predictive value of parental perception of hearing problems in their children. Parental suspicion of hearing problems was assessed by a questionnaire. Pure-tone air-conduction hearing thresholds were obtained from 0.5 to 8 kHz. Hearing loss was defined as a pure-tone average higher than 20 dB in one or both ears in at least one of the three following pure-tone averages: four-frequency pure-tone average, high-frequency pure-tone average, and low-frequency pure-tone average. ResultsPositive results of hearing screening were obtained in 16.3% of children. Hearing loss was detected in 6025 children (9.3%), of whom 1074 (17.8%) were correctly perceived by parents as having hearing problems. The degree of hearing loss was a significant factor which influenced the sensitivity of parental suspicion of HL in their children. Sensitivity of detecting hearing loss by parents reached about 20% for mild hearing loss and above 31% for moderate or worse hearing loss. ConclusionsParents underestimate hearing problems in their children, but they are more able to accurately detect hearing loss if it involves speech-related frequencies and is at least a moderate hearing loss or bilateral loss.

A National Survey of Hearing Loss in the Philippines.

This study aimed to estimate the prevalence of hearing loss in the Philippines using a nationally representative sample. A cross-sectional national survey was undertaken utilizing a 3-stage stratified cluster design. Participants in the present study comprised 2275 adults and children with pure tone hearing assessment results. Prevalence of moderate or worse hearing loss, defined as 4FA ≥41 dBHL, was 7.5% in children <18 years, 14.7% in adults between 18 and 65 years, and 49.1% in adults >65 years. Factors associated with greater risk of moderate hearing loss in the better ear were presence of a middle ear condition (adjusted odds ratio = 2.39, 95% confidence interval = 1.49-3.85) and socioeconomic status (household income; adjusted odds ratio = 1.64, 95% confidence interval = 1.23-2.19). Age was also associated with increased risk, with adjusted odds ratios varying with age category. Prevalence of wax occlusion and outer and middle ear disease was 12.2% and 14.2%, respectively. Prevalence of hearing loss, outer, and middle ear disease appear comparatively high in the Philippines when compared with rates reported in high-income countries. Higher proportions of severe to profound hearing loss were also identified, indicating that there is both an increased prevalence and severity of hearing loss in this population.

Cigarette Smoking, Smoking Cessation, and Risk of Hearing Loss in Women

BackgroundPrevious studies demonstrated higher risk of hearing loss among cigarette smokers, but longitudinal data on whether the risk is influenced by smoking cessation are limited. We prospectively investigated relations between smoking, smoking cessation, and risk of self-reported moderate or worse hearing loss among 81,505 women in the Nurses’ Health Study II (1991-2013). MethodsInformation on smoking and hearing status was obtained from validated biennial questionnaires. Cox proportional hazards regression was used to estimate multivariable-adjusted relative risks (MVRR, 95% confidence interval). ResultsDuring 1,533,214 person-years of follow-up, 2760 cases of hearing loss were reported. Smoking was associated with higher risk of hearing loss and the risk tended to be higher with greater number of pack-years smoked. Compared with never smokers, the MVRR (95% confidence interval) among past smokers with 20+ pack-years of smoking was 1.30 (1.09-1.55) and 1.21 (1.02-1.43) for current smokers. The magnitude of elevated risk diminished with greater time since smoking cessation. Compared with never smokers, the MVRR among smokers who quit <5 years prior was 1.43 (1.17-1.75); 5-9 years prior was 1.27 (1.03-1.56); 10-14 years prior was 1.17 (0.96-1.41); and plateaued thereafter. Additional adjustment for pack-years smoking attenuated the results. ConclusionsThe higher risk of hearing loss associated with smoking may diminish over time after quitting.

Detailed evaluation of hearing loss (HL) associated with high-dose (HD) carboplatin for salvage treatment of germ cell tumors (GCT).

401 Background: HD carboplatin is an essential part of curative salvage high-dose chemotherapy (HDCT) for GCT. Although ototoxicity is a known side effect of HD carboplatin, data on severity and characteristics of HL in this population are limited. Methods: Eligible patients (pts) received salvage HD carboplatin for GCT at our center from 1993-2017 and had audiograms pre- and post-HDCT. All pts were planned for 3 sequential cycles of HD carboplatin; some had audiograms after each cycle. HL severity was classified by ASHA criteria (slight: 15-24dB; mild: 25-40dB; moderate: 41-55dB; moderately severe: 56-70dB; severe: 71-90dB; profound: &gt;90dB). Change in hearing threshold at each frequency (0.25 – 8 kHz) was analyzed by clinical and treatment variables using the Wilcoxon rank-sum test. The proportion of pts recommended for hearing aids was also recorded. Results: Of 115 pts (median age 31, 77% nonseminoma), 96 received TI-CE and 19 received TI-TIC on a clinical trial (Feldman CGUC 2015). Pts varied by prior cisplatin exposure (77% with ≤4 vs 23% with 5-9 cycles) and number of HD carboplatin cycles (89% had 3, 10% had 2, and 2% had 1). Carboplatin AUC was 21 in 23%, 24 in 75%, and 28 in 3%. Moderate to profound HL was present in 23% pre-HD carboplatin vs 82% post, preferentially at high frequencies (Table). Of 89 pts with normal to mild HL at baseline, 78% developed moderate or worse HL post-HD carboplatin, including 61% with moderately severe or severe HL. Higher AUC (24 vs 21) and number of HD carboplatin cycles were associated with greater HL with HD carboplatin whereas prior cisplatin exposure was not. Due to moderate or severe HL in the vital speech frequency range (2 – 4kHz), 20 (17%) pts were recommended for hearing aids post-HD carboplatin. Conclusions: In the largest series to detail ototoxicity in pts receiving salvage HD carboplatin for GCT, we show HL, particularly at high frequencies, is a major dose-dependent toxicity. Most pts will have at least moderate high frequency HL after HD carboplatin with approximately 1 in 6 recommended for hearing aids. [Table: see text]

Progressive Hearing Loss in Children With Mild Bilateral Hearing Loss.

Purpose This study investigated progressive hearing loss in a cohort of children who were identified with permanent mild bilateral hearing loss. Method This population-based study included 207 children with permanent mild bilateral hearing loss, diagnosed and followed from 2003 to 2016 in 1 region of Canada. Clinical characteristics and initial audiologic results were collected prospectively at diagnosis, and audiologic information was updated. Changes in hearing levels between the 1st and most recent assessment were analyzed to determine progressive hearing loss. Clinical characteristics were compared between children with progressive and stable hearing loss. The association between risk indicators and progressive hearing loss was explored through logistic regression. Results A total of 47.4% (94 of 207) had progressive hearing loss in at least 1 ear, and 50% (47 of 94) of those experienced more than 20-dB average drop in thresholds. For these 94 children, a total of 147 ears were affected, and 116 (78.9%) ears experienced sufficient change in thresholds to be coded as a worse category of hearing loss. In the subset of 85 children with more than 5 years of audiologic follow-up, 56.4% (53/85) showed a decrease in hearing. Of the total sample of 207 children, 137 (66.2%) continued to have mild hearing loss in the better ear. There was no association between the risk factors examined (family history of hearing loss, admission to the neonatal intensive care unit, or presence of a syndrome) and progressive hearing loss. Conclusion This study found that almost half of children with mild bilateral hearing loss showed a decrease in hearing in at least 1 ear. One third of the children first diagnosed with mild hearing loss in the better ear now have moderate or worse hearing loss in both ears. These findings point to the importance of careful long-term monitoring of children who present with mild hearing loss.

Prevalence of hearing loss among polish school-age children from rural areas – Results of hearing screening program in the sample of 67 416 children

BackgroundHearing loss in children is a relevant health issue, both for its prevalence and for its physical, emotional and social consequences. Our aim was to estimate the national prevalence of hearing loss in school-age children from rural areas in Poland. MethodsThe study was conducted in the general, pediatric, nonclinical population of school-age children from rural areas in Poland. It was a population-based, epidemiological study. The participants were 67416 children (32630 girls and 34786 boys) aged from 6 to 13 years old (M = 8.65; SD = 2.54). Pure-tone air-conduction hearing threshold were obtained at 0.5–8 kHz. Hearing loss was defined as a pure-tone average higher than 20 dB in one or both ears in at least one of the following pure-tone average: four-frequency pure-tone average (FFPTA), high-frequency pure-tone average (HFPTA) and low-frequency pure-tone average (LFPTA). ResultsThe rate of positive results of hearing screening was 16.4% and it was significantly higher in younger children than in older children. Mild hearing loss was more frequently than moderate or worse hearing loss. The children more often experienced unilateral than bilateral hearing loss. ConclusionsThis study reveals that hearing problems are common in this population, especially among younger children. It shows a strong need for systematic monitoring of hearing status among children and increasing awareness of parents and educators of the significance of hearing loss, including unilateral and mild hearing loss. Further studies conducted among children in urban areas are needed to compare the prevalence of hearing loss in children from various environments.

Characteristics and progression of hearing loss in children with turner's syndrome.

Evaluate patterns of hearing impairment in children with Turner's syndrome (TS) and determine factors influencing severity and progression. Retrospective database review. Demographic, audiological, and medical data for children with TS were extracted from the Audiological and Genetic Database to analyze patterns of hearing loss with comorbidities, demographics, and interventions. Two hundred seventy-two children with TS were identified; 213 had audiological data. Of these children, 72.3% (N = 154) had hearing loss in which 84.4% (N = 130) was bilateral. In individual ears, conductive hearing loss was most common (28.7%, n = 73), followed by mixed (22.0%, n = 93) and sensorineural (7.9%, n = 20). Otitis media (odds ratio [OR] = 2.7, 95% confidence interval [CI]: 1.2-6.5), eustachian tube dysfunction (OR = 9.5, 95% CI: 3.2-35.2), and aortic valve anomalies were also associated with higher rates of hearing loss (OR = 3.6, 95% CI: 1.3-11.5). Of ears with quantifiable severity, 16.3% (n = 40) had moderate or worse hearing loss. Aortic coarctation (36.3 vs. 21.3 dB, P < .001), seizures (40.6 vs. 21.3 dB, P = .006), facial anomalies (32.5 vs. 21.3 dB, P = .029), and hypertension (36.3 vs. 21.3 dB, P = .015) portended more severe loss. Children with TS have high rates of hearing loss. High rates of sensorineural loss were unexpected. Nonotologic comorbidities, including seizures, hypertension, and anomalies of the kidney and aorta were associated with greater prevalence, severity, and progression of loss. Children with TS, particularly with the above comorbidities, are at risk for poor hearing outcomes, and should be offered audiological intervention to efficiently direct patient care. NA Laryngoscope, 130:1540-1546, 2020.

Biomarkers of Systemic Inflammation and Risk of Incident Hearing Loss.

Chronic inflammation may lead to cochlear damage, and the only longitudinal study that examined biomarkers of systemic inflammation and risk of hearing loss found an association with a single biomarker in individuals <60 years of age. The purpose of our study was to determine whether plasma inflammatory markers are associated with incident hearing loss in two large prospective cohorts, Nurses' Health Studies (NHS) I and II. We examined the independent associations between plasma levels of markers of systemic inflammation (C-reactive protein [CRP], interleukin-6 [IL-6], and soluble tumor necrosis factor receptor 2 [TNFR-2]) and self-reported hearing loss. The participants in NHS I (n = 6194 women) were 42 to 69 years of age at the start of the analysis in 1990, while the participants in NHS II (n = 2885 women) were 32 to 53 years in 1995. After excluding women with self-reported hearing loss before the time of blood-draw, incident cases of hearing loss were defined as those women who reported hearing loss on questionnaires administered in 2012 in NHS I and 2009 or 2013 in NHS II. The primary outcome was hearing loss that was reported as moderate or worse in severity, pooled across the NHS I and NHS II cohorts. We also examined the pooled multivariable-adjusted hazard ratios for mild or worse hearing loss. Cox proportional hazards regression was used to adjust for potential confounders. At baseline, women ranged from 42 to 69 years of age in NHS I and 32 to 53 years of age in NHS II. Among the NHS I and II women with measured plasma CRP, there were 628 incident cases of moderate or worse hearing loss during 100,277 person-years of follow-up. There was no significant association between the plasma levels of any of the three inflammatory markers and incident moderate or worse hearing loss (multivariable-adjusted pooled p trend for CRP = 0.33; p trend IL-6 = 0.54; p trend TNFR-2 = 0.70). There was also no significant relation between inflammatory marker levels and mild or worse hearing loss. While there was no significant effect modification by age for CRP or IL-6 in NHS I, there was a statistically significant higher risk of moderate or worse hearing loss (p interaction = 0.02) as well as mild or worse hearing loss (p interaction = 0.004) in women ≥60 years of age who had higher plasma TNFR-2 levels. Overall, there was no significant association between plasma markers of inflammation and risk of hearing loss.

Hearing Loss and Depression in the Hispanic/Latino Population

Hearing Loss and Depression in the Hispanic/Latino Population

A Mobile Phone-Based Approach for Hearing Screening of School-Age Children: Cross-Sectional Validation Study.

BackgroundPure-tone screening (PTS) is considered as the gold standard for hearing screening programs in school-age children. Mobile devices, such as mobile phones, have the potential for audiometric testing.ObjectiveThis study aimed to demonstrate a new approach to rapidly screen hearing status and provide stratified test values, using a smartphone-based hearing screening app, for each screened ear of school-age children.MethodThis was a prospective cohort study design. The proposed smartphone-based screening method and a standard sound-treated booth with PTS were used to assess 85 school-age children (170 ears). Sound-treated PTS involved applying 4 test tones to each tested ear: 500 Hz at 25 dB and 1000 Hz, 2000 Hz, and 4000 Hz at 20 dB. The results were classified as pass (normal hearing in the ear) or fail (possible hearing impairment). The proposed smartphone-based screening employs 20 stratified hearing scales. Thresholds were compared with those of pure-tone average (PTA).ResultsA total of 85 subjects (170 ears), including 38 males and 47 females, aged between 11 and 12 years with a mean (SD) of 11 (0.5) years, participated in the trial. Both screening methods produced comparable pass and fail results (pass in 168 ears and fail in 2 ears). The smartphone-based screening detected moderate or worse hearing loss (average PTA>25 dB) accurately. Both the sensitivity and specificity of the smartphone-based screening method were calculated at 100%.ConclusionsThe results of the proposed smartphone-based self-hearing test demonstrated high concordance with conventional PTS in a sound-treated booth. Our results suggested the potential use of the proposed smartphone-based hearing screening in a school-age population.